| NPI | 1295389252 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CA LPCC16132) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CA APCC8568) |
| 101YP2500X Counselor Professional (Licence: CA APCC8568) | |
| Enumeration Date | 2019-07-29 |
| Last Update Date | 2024-04-16 |